Pirkola Sami, Isometsä Erkki, Lönnqvist Jouko
Department of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland.
J Nerv Ment Dis. 2003 Nov;191(11):745-50. doi: 10.1097/01.nmd.0000095127.16296.c1.
It is unclear whether suicides by different methods are distinguishable by their sociodemographic or clinical characteristics. We set out to investigate whether completed suicides by different methods show disparities in their sociodemographic and clinical characteristics. Within the National Suicide Prevention Project in Finland, all 1,397 suicides occurring April 1, 1987, through March 31, 1988, were investigated using the psychological autopsy method. Disparities were found in characteristics of suicide completers using different methods. Intoxication suicides were more often female and had a history of both previous attempts and psychiatric treatment, whereas suicides by shooting were the opposite in character. Victims using vehicle exhaust gas were most frequently younger males who had experienced a recent interpersonal loss or other adverse event and committed suicide while intoxicated with alcohol. Thus, typical characteristics associate with certain suicide methods, probably due to differences in availability and acceptability of the methods. Various restrictions on the availability of suicide methods are likely to exert their possible impact on somewhat different subpopulations at risk. In terms of suicide prevention, it seems reasonable to target availability restrictions for certain identifiable groups of potential suicide attempters. For instance, carefulness in the practice of prescribing of intoxicating substances to particular psychiatric patients seems justified.
目前尚不清楚不同方式自杀是否可通过社会人口统计学或临床特征加以区分。我们着手调查不同方式的自杀既遂在社会人口统计学和临床特征方面是否存在差异。在芬兰国家预防自杀项目中,采用心理解剖法对1987年4月1日至1988年3月31日期间发生的所有1397例自杀案例进行了调查。结果发现,采用不同方式自杀的既遂者在特征上存在差异。中毒自杀者女性居多,且有既往自杀未遂史和接受过精神科治疗,而枪击自杀者的特征则相反。使用汽车尾气自杀的受害者大多是年轻男性,他们近期经历了人际损失或其他不良事件,且在酒精中毒状态下自杀。因此,某些自杀方式具有典型特征,这可能是由于自杀方式的可得性和可接受性存在差异所致。对自杀方式可得性的各种限制可能会对不同的高危亚人群产生不同的影响。就预防自杀而言,针对某些可识别的潜在自杀未遂者群体限制自杀方式的可得性似乎是合理的。例如,谨慎地向特定精神科患者开具致醉物质似乎是有道理的。